As the railroad industry expanded westward, the need for medical care for its employees working in remote areas was evident.

To meet that demand, the railroad became an early adopter of employer-based health care decades before it became popular.

At the beginning of the 20th century, every major railroad had doctors on its payroll. They cared not only for railroad employees but also for passengers and those injured along the rail lines, too. The doctors treated minor aches and pains, passenger childbirth and the critically injured. They were typically associated with local hospitals or railroad-established medical facilities in rural areas.

Rail yards posed many hazards, but the most dangerous job was the coupling and uncoupling of engines and cars. Because of these unique risks, a railroad surgeon encountered gruesome injuries that other doctors rarely saw.

A surgeon was often called upon in crashes along the railroad, treating employees, riders, victims in passenger cars and, in many cases, people who fell on the tracks. The doctors were often the first responders to accidents involving traumatic injuries, such as mangled and crushed bodies. The railroad surgeon developed some of the techniques and treatments used by trauma surgeons today.

A scene from the wreckage of the train carrying the Purdue University football team in 1903. The team occupied the first car, resulting in the deaths of 13 players as well as an assistant coach and trainer. The second car (right) jumped the track and went down an embankment.(Photo: Indianapolis News file photo, )

When Leonard Ensminger retired as chief physician of the New York Central System in Indianapolis in 1947, he recalled several tragedies in his 47 years with the railroad. The worst was a 1903 wreck that killed 17 people aboard the Purdue University football special. “They worked two days without a pause, caring for the injured,” he said.

Under Ensminger, the railroad began periodic physical examinations for its employees and was in charge of regulations for food handling on trains and supplying pure water for diners and passenger cars.

The Toledo, St. Louis & Western Railroad, which operated in Indiana, constructed a railroad hospital car at its shop in Frankfort. The car was equipped with a stateroom with two berths. An operating room was supplied with a complete surgical outfit and swinging operating tables. The moving hospital service was a novel idea, giving a surgeon a sterile, well-equipped environment in which to work. It allowed him to stabilize the patient, before sending him or her off to the nearest hospital.

The Association of Railroad Surgeons, which often held their annual conferences in Indianapolis, advocated carrying special medical packs on trains. The packs were stocked with emergency medical supplies and employees were trained to use the contents to provide medical aid until a surgeon could arrive. These medical packs were the prototype of the modern first-aid kit.

In the early 1900s through the Great Depression, railroad surgeons treated injuries suffered by train-hopping tramps and hobos. “Tramps,” referred to as the lower class of vagrant in a 1915 Indianapolis Star article, were thought to be carriers of disease. Railroad surgeons had to address the “transportation of consumptives” from one town to the next, ordering a regular cleaning of railcars and boxcars, especially during epidemics.

Railroad surgeons faded in the 1950s, but they left a legacy of frontline trauma care.

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In 1853: America's first "union" railway depot - an idea to be duplicated across the nation - was built in Indianapolis. It was the first time in America that all railroad trains could enter and leave a city from a single central station.
In 1888: The new three-story Romanesque Revival Style station designed by Pittsburgh architect Thomas Rodd replaced the old station. This structure is known as "Grand Hall". Kelly Wilkinson Indianapolis Star

llustration showing the first Indianapolis Union Station and the first union station in the world. The depot was completed in 1853 and occupied the site of the present station. The original depot was bounded by Capitol Ave (then Tennessee St.) Meridian, McNabb and Louisiana streets. The Bellefontaine, the Indiana Central and the Indianapolis & Cincinnati and the Madison & Indianapolis railroads built the depot. The original station opened Sept. 20, 1853. The much larger station we have today opened in Sept. 1888. The head house and clock tower of the station are all the remains. FILE

In the early 20th Century it seemed a given that as long as population grew, so would the need for trains. In 1920, Union Station was averaging 176 trains a day -- and this was not counting all of the electric rail traffic in the city. The Traction Terminal, several blocks north, had become the busiest interurban hub in the nation. Though both used rails, the electric-powered interurbans were competitors of the steam-powered trains that went through Union Station. Star file photo

The focal point of Indianapolis' Union Station is the head house illuminated during the day by stained-glass wheel windows at each end. The building designed by Thomas Rodd of Pittsburgh was built in 1887-88. As many as 200 passenger trains passed through Union Station each day at the beginning of the century but train travel decreased throughout the 1900s. In this photograph from Oct. 18 1950 porters assist train passengers in the center of the grand hall. News photo by Robert Lavelle STAR/NEWS

After the war, the interurbans were gone, but passenger trains were declining also as the automobile and aviation industries both experienced rapid growth. In the 1960s, many of the once-powerful railroad firms were going broke. What remained of passenger rail travel was consolidated into the government-supported Amtrak system, but only a few trains a day came through Indianapolis. Horace Ketring

Union Station Red Cap Lang Wilson was framed in a cloud of steam from Amtrak's National Limited, the only passenger train serving Indianapolis on November 23, 1977. The station once served 100 trains and thousands of bustling travelers every day, but by 1977 its long marbled hallways and arched ceilings were a mere echo chamber awaiting renovation, stalled for lack of money and interest. The renovation eventually came, and in 1986 Union Station opened as a festival marketplace. By January 1997, only three restaurants and 10 specialty shops remained, so on March 31, 1997 the marketplace closed. Today, Amtrak trains and Greyhound Bus services operate out of a building at the station, on the west side of Illinois Street. Photo by Indianapolis Star photographer Jerry Clark STAR/NEWS

Union Station was owned by Penn Central, the weak descendant of the old Pennsylvania Railroad, and for a while it looked like the station would be bulldozed into a parking lot. Mayor Richard Lugar led the effort to save the station. It was added to the National Register of Historic Places in 1974, which at least protected it from demolition. Track entrances for the Pennsylvania Railroad. William Oates/The Star 1958 file photo William Oates/The Star

In the late 1980s, with much fanfare and hopes, the station was converted to house shops and restaurants -- a "festival marketplace" was the term the promoters used. It was not a success, though it managed to stay open in that capacity for about a decade. D. Todd Moore/The Star

Jackson Place with Union Station at right. Date unknown but pre-1905 when the buildings in the center of the photo were destroyed in a fire.. Also in this photo: McConney Tobacco, St. Charles Hotel which had a sample room and restaurant for imported beers, Griffith Bros. Wholesale Millinery, A. Kiefer rug co, Fahnley & McCrea Millinery file photo

The Star headline on this orginal Nov. 23, 1946 publication read "Bent Eagles Flock Together As 'Hogwash Hoagy' Hits town." The songwriter was greeted by classmates, friends and members of the notorious "Bent Eagles", at Union Station for a series of events in Indianapolis and Bloomington. He is shouldering a "three-foot key" after a presentation by John A. Schumacher (left), president of the City Council. At right are Mrs. Russell Williams and Mrs. Ford Kaufmann, who later represented St. Margaret's Hospital Guild as hostesses at the reception at the Athletic Club. JOSEPH E. CRAVEN